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Sharifzadeh Javidi S, Shirazinodeh A, Saligheh Rad H. Intravoxel Incoherent Motion Quantification Dependent on Measurement SNR and Tissue Perfusion: A Simulation Study. J Biomed Phys Eng 2023; 13:555-562. [PMID: 38148961 PMCID: PMC10749416 DOI: 10.31661/jbpe.v0i0.2102-1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/28/2021] [Indexed: 12/28/2023]
Abstract
Background The intravoxel incoherent motion (IVIM) model extracts both functional and structural information of a tissue using motion-sensitizing gradients. Objective The Objective of the present work is to investigate the impact of signal to noise ratio (SNR) and physiologic conditions on the validity of IVIM parameters. Material and Methods This study is a simulation study, modeling IVIM at a voxel, and also done 10,000 times for every single simulation. Complex noises with various standard deviations were added to signal in-silico to investigate SNR effects on output validity. Besides, some blood perfusion situations for different tissues were considered based on their physiological range to explore the impacts of blood fraction at each voxel on the validity of the IVIM outputs. Coefficient variation (CV) and bias of the estimations were computed to assess the validity of the IVIM parameters. Results This study has shown that the validity of IVIM output parameters highly depends on measurement SNR and physiologic characteristics of the studied organ. Conclusion IVIM imaging could be useful if imaging parameters are correctly selected for each specific organ, considering hardware limitations.
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Affiliation(s)
- Sam Sharifzadeh Javidi
- Department of Medical Physics and Biomedical Engineering, Medicine School, Tehran University of Medical Sciences, Tehran, Iran
- Quantitative Medical Imaging Systems Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shirazinodeh
- Department of Medical Physics and Biomedical Engineering, Medicine School, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Saligheh Rad
- Department of Medical Physics and Biomedical Engineering, Medicine School, Tehran University of Medical Sciences, Tehran, Iran
- Quantitative Medical Imaging Systems Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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Mastropietro A, Procissi D, Scalco E, Rizzo G, Bertolino N. A supervised deep neural network approach with standardized targets for enhanced accuracy of IVIM parameter estimation from multi-SNR images. NMR IN BIOMEDICINE 2022; 35:e4774. [PMID: 35587618 PMCID: PMC9539583 DOI: 10.1002/nbm.4774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
Extraction of intravoxel incoherent motion (IVIM) parameters from noisy diffusion-weighted (DW) images using a biexponential fitting model is computationally challenging, and the reliability of the estimated perfusion-related quantities represents a limitation of this technique. Artificial intelligence can overcome the current limitations and be a suitable solution to advance use of this technique in both preclinical and clinical settings. The purpose of this work was to develop a deep neural network (DNN) approach, trained on numerical simulated phantoms with different signal to noise ratios (SNRs), to improve IVIM parameter estimation. The proposed approach is based on a supervised fully connected DNN having 3 hidden layers, 18 inputs and 3 targets with standardized values. 14 × 103 simulated DW images, based on a Shepp-Logan phantom, were randomly generated with varying SNRs (ranging from 10 to 100). 7 × 103 images (1000 for each SNR) were used for training. Performance accuracy was assessed in simulated images and the proposed approach was compared with the state-of-the-art Bayesian approach and other DNN algorithms. The DNN approach was also evaluated in vivo on a high-field MRI preclinical scanner. Our DNN approach showed an overall improvement in accuracy when compared with the Bayesian approach and other DNN methods in most of the simulated conditions. The in vivo results demonstrated the feasibility of the proposed approach in real settings and generated quantitative results comparable to those obtained using the Bayesian and unsupervised approaches, especially for D and f, and with lower variability in homogeneous regions. The DNN architecture proposed in this work outlines two innovative features as compared with other studies: (1) the use of standardized targets to improve the estimation of parameters, and (2) the implementation of a single DNN to enhance the IVIM fitting at different SNRs, providing a valuable alternative tool to compute IVIM parameters in conditions of high background noise.
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Affiliation(s)
| | - Daniel Procissi
- Department of RadiologyNorthwestern UniversityChicagoIllinoisUSA
| | - Elisa Scalco
- Istituto di Tecnologie BiomedicheConsiglio Nazionale delle RicercheSegrateItaly
| | - Giovanna Rizzo
- Istituto di Tecnologie BiomedicheConsiglio Nazionale delle RicercheSegrateItaly
| | - Nicola Bertolino
- Department of RadiologyNorthwestern UniversityChicagoIllinoisUSA
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Ahangari S, Littrup Andersen F, Liv Hansen N, Jakobi Nøttrup T, Berthelsen AK, Folsted Kallehauge J, Richter Vogelius I, Kjaer A, Espe Hansen A, Fischer BM. Multi-parametric PET/MRI for enhanced tumor characterization of patients with cervical cancer. Eur J Hybrid Imaging 2022; 6:7. [PMID: 35378619 PMCID: PMC8980118 DOI: 10.1186/s41824-022-00129-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Aim
The concept of personalized medicine has brought increased awareness to the importance of inter- and intra-tumor heterogeneity for cancer treatment. The aim of this study was to explore simultaneous multi-parametric PET/MRI prior to chemoradiotherapy for cervical cancer for characterization of tumors and tumor heterogeneity.
Methods
Ten patients with histologically proven primary cervical cancer were examined with multi-parametric 68Ga-NODAGA-E[c(RGDyK)]2-PET/MRI for radiation treatment planning after diagnostic 18F-FDG-PET/CT. Standardized uptake values (SUV) of RGD and FDG, diffusion weighted MRI and the derived apparent diffusion coefficient (ADC), and pharmacokinetic maps obtained from dynamic contrast-enhanced MRI with the Tofts model (iAUC60, Ktrans, ve, and kep) were included in the analysis. The spatial relation between functional imaging parameters in tumors was examined by a correlation analysis and joint histograms at the voxel level. The ability of multi-parametric imaging to identify tumor tissue classes was explored using an unsupervised 3D Gaussian mixture model-based cluster analysis.
Results
Functional MRI and PET of cervical cancers appeared heterogeneous both between patients and spatially within the tumors, and the relations between parameters varied strongly within the patient cohort. The strongest spatial correlation was observed between FDG uptake and ADC (median r = − 0.7). There was moderate voxel-wise correlation between RGD and FDG uptake, and weak correlations between all other modalities. Distinct relations between the ADC and RGD uptake as well as the ADC and FDG uptake were apparent in joint histograms. A cluster analysis using the combination of ADC, FDG and RGD uptake suggested tissue classes which could potentially relate to tumor sub-volumes.
Conclusion
A multi-parametric PET/MRI examination of patients with cervical cancer integrated with treatment planning and including estimation of angiogenesis and glucose metabolism as well as MRI diffusion and perfusion parameters is feasible. A combined analysis of functional imaging parameters indicates a potential of multi-parametric PET/MRI to contribute to a better characterization of tumor heterogeneity than the modalities alone. However, the study is based on small patient numbers and further studies are needed prior to the future design of individually adapted treatment approaches based on multi-parametric functional imaging.
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Andersson M, Jalnefjord O, Montelius M, Rizell M, Sternby Eilard M, Ljungberg M. Evaluation of response in patients with hepatocellular carcinoma treated with intratumoral dendritic cell vaccination using intravoxel incoherent motion (IVIM) MRI and histogram analysis. Acta Radiol 2021; 64:32-41. [PMID: 34904868 DOI: 10.1177/02841851211065935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Immunotherapy of hepatocellular carcinoma (HCC) is an emerging method with promising results. Immunotherapy can have an antitumor effect without affecting tumor size, calling for functional imaging methods for response evaluation. PURPOSE To evaluate the response to intratumoral injections with the immune primer ilixadencel in HCCs with diffusion-weighted magnetic resonance imaging (DW-MRI) using intravoxel incoherent motion (IVIM) and histogram analysis. MATERIAL AND METHODS A total of 17 patients with advanced HCC were treated with intratumoral injections with ilixadencel on three occasions 2-5 weeks apart. The patients were examined with IVIM before each injection as well as approximately three months after the first injection. RESULTS The 10th percentile of perfusion-related parameter D* decreased significantly after the first and second intratumoral injections of ilixadencel compared to baseline (P < 0.05). There was a non-significant trend of lower median region of interest f (perfusion fraction) before injection 2 compared to baseline (P = 0.07). There were significant correlations between the 10th percentile and median of D at baseline and change in tumor size after three months (r = 0.79, P < 0.01 and r = 0.72, P < 0.05, respectively). CONCLUSION DW-MRI with IVIM and histogram analysis revealed significant reductions of D* early after treatment as well as an association between D at baseline and smaller tumor growth at three months. The lower percentiles (10th and 50th) were found more important. Further research is needed to confirm our preliminary findings of reduced perfusion after ilixadencel vaccinations, suggesting a treatment effect on HCC.
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Affiliation(s)
- Mats Andersson
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Oscar Jalnefjord
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Montelius
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Rizell
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Sternby Eilard
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Ljungberg
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
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Luo H, He L, Cheng W, Gao S. The diagnostic value of intravoxel incoherent motion imaging in differentiating high-grade from low-grade gliomas: a systematic review and meta-analysis. Br J Radiol 2021; 94:20201321. [PMID: 33876653 DOI: 10.1259/bjr.20201321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This meta-analysis was carried out for assessing the accuracy of intravoxel incoherent motion (IVIM) parameters true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). METHODS Literatures concerning IVIM in the grading of brain gliomas published prior to October 20, 2020, searched in the Embase, PubMed, and Cochrane library. Use the quality assessment of diagnostic accuracy studies 2 (QUADAS 2) to evaluate the quality of studies. We estimated the pooled sensitivity, specificity, and the area under the summary ROC (SROC) curve to identification the accuracy of IVIM parameters D, D*, and f evaluation in grading gliomas. RESULTS Totally, 6 articles including 252 brain gliomas conform to the inclusion criteria. The pooled sensitivity of parameters D, D*, and f derived from IVIM were 0.85 (95%Cl, 0.76-0.91), 0.78 (95%Cl, 0.71-0.85), and 0.89 (95%Cl, 0.76-0.96), respectively. The pooled specificity were 0.78 (95%Cl, 0.60-0.90), 0.68 (95%Cl, 0.56-0.79), and 0.88 (95%Cl, 0.76-0.94), respectively. Meanwhile, the AUC of SROC curve were 0.89 (95%Cl, 0.86-0.92) , 0.81 (95%Cl, 0.77-0.84), and 0.94 (95%Cl, 0.92-0.96), respectively. CONCLUSION This meta-analysis suggested that IVIM parameters D, D*, and f have moderate or high diagnosis value accuracy in differentiating HGGs from LGGs, and the parameter f has greater sensitivity and specificity. Standardized methodology is warranted to guide the use of this method for clinical decision-making. However, more clinical studies are needed to prove our view. ADVANCES IN KNOWLEDGE IVIM parameter f showed greater sensitivity and specificity, as well as excellent performance than parameter D* and D.
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Affiliation(s)
- Hechuan Luo
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ling He
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Weiqin Cheng
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Sijie Gao
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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Association between IVIM parameters and treatment response in locally advanced squamous cell cervical cancer treated by chemoradiotherapy. Eur Radiol 2021; 31:7845-7854. [PMID: 33786654 DOI: 10.1007/s00330-021-07817-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/07/2021] [Accepted: 02/19/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the associations of intravoxel incoherent motion (IVIM) parameters with treatment response in cervical cancer following concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS Forty-five patients, median age of 58 years (range: 28-82), with pre-CCRT and post-CCRT MRI, were retrospectively analysed. The IVIM parameters pure diffusion coefficient (D) and perfusion fraction (f) were estimated using the full b-value distribution (BVD) as well as an optimised subsample BVD. Dice similarity coefficient (DSC) and intraclass correlation coefficient (ICC) were used to measure observer repeatability in tumour delineation at both time points. Treatment response was determined by the response evaluation criteria in solid tumour (RECIST) 1.1 between MRI examinations. Mann-Whitney U tests were used to test for significant differences in IVIM parameters between treatment response groups. RESULTS Pre-CCRT tumour delineation repeatability was good (DSC = 0.81) while post-CCRT delineation repeatability was moderate (DSC = 0.67). Values of D and f had good repeatability at both time points (ICC > 0.80). Pre-CCRT f estimated using the full BVD and optimised subsample BVD were found to be significantly higher in patients with partial response compared to those with stable disease or disease progression (p = 0.01 and 95% CI = -0.02-0.00 for both cases). CONCLUSION Pre-CCRT f was associated with treatment response in cervical cancer with good observer repeatability. Similar discriminative ability was also observed in estimated pre-CCRT f from an optimised subsample BVD. KEY POINTS • Pre-treatment tumour delineation and IVIM parameters had good observer repeatability. • Post-treatment tumour delineation was worse than at pre-treatment, but IVIM parameters retained good ICC. • Pre-treatment perfusion fraction estimated from all b-values and an optimised subsample of b-values were associated with treatment response.
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Feasibility of intravoxel incoherent motion diffusion-weighted imaging in distinguishing adenocarcinoma originated from uterine corpus or cervix. Abdom Radiol (NY) 2021; 46:732-744. [PMID: 32671441 DOI: 10.1007/s00261-020-02586-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To prospectively assess the incremental value of intravoxel incoherent motion (IVIM) DWI in determining whether the adenocarcinoma originated from the uterine corpus or cervix. METHODS Eighty consecutive uterine adenocarcinomas from the cervix or endometrium confirmed by histopathology underwent IVIM DWI acquisition on a 3.0T MR scanner before treatment. Five morphologic features were analyzed using Fisher exact test; IVIM DWI-derived parameters, including apparent diffusion coefficient (ADC), true coefficient diffusivity (D), perfusion-related diffusivity (D*), and perfusion fraction (f) were compared using two-sample independent t-test or Mann-Whitney U test. Logistic regression analysis was used to develop different diagnosis model. The ROCs of these variables and diagnostic models were compared to evaluate the diagnostic efficiency. RESULTS Among single morphologic features, tumor location yielded the highest AUC of 0.891 in distinguishing endometrial adenocarcinoma (EAC) from cervical adenocarcinoma (CAC). Among single IVIM DWI-derived parameters, f values showed the best diagnostic performance (AUC: 0.837) at the optimal cut-off value of 0.261. Additionally, the combined diagnostic model, which consisted of tumor location, ADC and f showed the largest AUC of 0.967 with the highest sensitivity of 88.14%, highest specificity of 100.00%, and highest accuracy of 91.25%. CONCLUSION IVIM DWI-derived parameters add additional diagnostic value to conventional morphologic features. A combined diagnosis model is a promising imaging tool for predicting the origin of uterine adenocarcinoma, further contributing to therapeutic decision-making.
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Cai SQ, Li Y, Li YA, Wang L, Zhu J, Zhao SH, Qiang JW. Perfusion-based functional magnetic resonance imaging for differentiating serous borderline ovarian tumors from early serous ovarian cancers in a rat model. Acta Radiol 2021; 62:129-138. [PMID: 32276553 DOI: 10.1177/0284185120913711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Differentiation of borderline tumors from early ovarian cancer has recently received increasing attention, since borderline tumors often affect young women of childbearing age who desire to preserve fertility. However, previous studies have demonstrated that non-enhanced magnetic resonance imaging (MRI) sequences cannot sufficiently differentiate these tumors. PURPOSE To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating serous borderline ovarian tumors (SBOT) from early serous ovarian cancers (eSOCA). MATERIAL AND METHODS Twenty SBOT and 20 eSOCA rat models were performed with DCE-MRI and IVIM-DWI at 3.0-T MR scanner. Qualitative and quantitative parameters of DCE-MRI were acquired and compared between two groups and correlated with the microvessel density (MVD). The receiver operating characteristic (ROC) curve analyses were conducted to determine their differentiating performances. RESULTS SBOTs presented significantly lower values of the initial area under the enhancement curve (iAUC), volume transfer constant (Ktrans), and extracellular extravascular volume fraction (ve) (P < 0.05) and a significantly higher value of true diffusion (D) (P = 0.001) compared with eSOCAs. The diagnostic effectiveness of ve combined with D was significantly better than that of ve or Ktrans alone (P ≤ 0.039). CONCLUSION DCE-MRI may represent a promising tool for differentiating SBOTs from eSOCAs and may not be replaced by IVIM-DWI. Combining DCE-MRI with DWI may improve the diagnostic performance of ovarian tumors.
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Affiliation(s)
- Song-Qi Cai
- Department of Radiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Ying Li
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Yong-Ai Li
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Li Wang
- Department of Pathology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Jian Zhu
- Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Shu-Hui Zhao
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, PR China
| | - Jin-Wei Qiang
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
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Carlisle N, Glazewska-Hallin A, Story L, Carter J, Seed PT, Suff N, Giblin L, Hutter J, Napolitano R, Rutherford M, Alexander DC, Simpson N, Banerjee A, David AL, Shennan AH. CRAFT (Cerclage after full dilatation caesarean section): protocol of a mixed methods study investigating the role of previous in-labour caesarean section in preterm birth risk. BMC Pregnancy Childbirth 2020; 20:698. [PMID: 33198663 PMCID: PMC7667480 DOI: 10.1186/s12884-020-03375-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Full dilatation caesarean sections are associated with recurrent early spontaneous preterm birth and late miscarriage. The risk following first stage caesarean sections, are less well defined, but appears to be increased in late-first stage of labour. The mechanism for this increased risk of late miscarriage and early spontaneous preterm birth in these women is unknown and there are uncertainties with regards to clinical management. Current predictive models of preterm birth (based on transvaginal ultrasound and quantitative fetal fibronectin) have not been validated in these women and it is unknown whether the threshold to define a short cervix (≤25 mm) is reliable in predicting the risk of preterm birth. In addition the efficacy of standard treatments or whether benefit may be derived from prophylactic interventions such as a cervical cerclage is unknown. METHODS There are three distinct components to the CRAFT project (CRAFT-OBS, CRAFT-RCT and CRAFT-IMG). CRAFT-OBS Observational Study; To evaluate subsequent pregnancy risk of preterm birth in women with a prior caesarean section in established labour. This prospective study of cervical length and quantitative fetal fibronectin data will establish a predictive model of preterm birth. CRAFT-RCT Randomised controlled trial arm; To assess treatment for short cervix in women at high risk of preterm birth following a fully dilated caesarean section. CRAFT-IMG Imaging sub-study; To evaluate the use of MRI and transvaginal ultrasound imaging of micro and macrostructural cervical features which may predispose to preterm birth in women with a previous fully dilated caesarean section, such as scar position and niche. DISCUSSION The CRAFT project will quantify the risk of preterm birth or late miscarriage in women with previous in-labour caesarean section, define the best management and shed light on pathological mechanisms so as to improve the care we offer to women and their babies. TRIAL REGISTRATION CRAFT was prospectively registered on 25th November 2019 with the ISRCTN registry ( https://doi.org/10.1186/ISRCTN15068651 ).
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Affiliation(s)
- Naomi Carlisle
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Agnieszka Glazewska-Hallin
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Lisa Story
- Centre for the Developing Brain, King's College London, 1st Floor South Wing, St Thomas' Hospital, London, SE1 7EH, UK
| | - Jenny Carter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Paul T Seed
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Natalie Suff
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Lucie Giblin
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Jana Hutter
- Centre for the Developing Brain, King's College London, 1st Floor South Wing, St Thomas' Hospital, London, SE1 7EH, UK
| | - Raffaele Napolitano
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Room 244, Medical School Building, Huntley Street, London, WC1E 6AU, UK
| | - Mary Rutherford
- Centre for the Developing Brain, King's College London, 1st Floor South Wing, St Thomas' Hospital, London, SE1 7EH, UK
| | - Daniel C Alexander
- Department of Computer Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nigel Simpson
- Delivery Suite, C Floor, Clarendon Wing, The General Infirmary at Leeds, Belmont Grove, Leeds, LS2 9NS, UK
| | - Amrita Banerjee
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Room 244, Medical School Building, Huntley Street, London, WC1E 6AU, UK
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Room 244, Medical School Building, Huntley Street, London, WC1E 6AU, UK.,NIHR University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road, London, W1T 7DN, UK
| | - Andrew H Shennan
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
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Perucho JAU, Chang HCC, Vardhanabhuti V, Wang M, Becker AS, Wurnig MC, Lee EYP. B-Value Optimization in the Estimation of Intravoxel Incoherent Motion Parameters in Patients with Cervical Cancer. Korean J Radiol 2020; 21:218-227. [PMID: 31997597 PMCID: PMC6992446 DOI: 10.3348/kjr.2019.0232] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022] Open
Abstract
Objective This study aimed to find the optimal number of b-values for intravoxel incoherent motion (IVIM) imaging analysis, using simulated and in vivo data from cervical cancer patients. Materials and Methods Simulated data were generated using literature pooled means, which served as reference values for simulations. In vivo data from 100 treatment-naïve cervical cancer patients with IVIM imaging (13 b-values, scan time, 436 seconds) were retrospectively reviewed. A stepwise b-value fitting algorithm calculated optimal thresholds. Feed forward selection determined the optimal subsampled b-value distribution for biexponential IVIM fitting, and simplified IVIM modeling using monoexponential fitting was attempted. IVIM parameters computed using all b-values served as reference values for in vivo data. Results In simulations, parameters were accurately estimated with six b-values, or three b-values for simplified IVIM, respectively. In vivo data showed that the optimal threshold was 40 s/mm2 for patients with squamous cell carcinoma and a subsampled acquisition of six b-values (scan time, 198 seconds) estimated parameters were not significantly different from reference parameters (individual parameter error rates of less than 5%). In patients with adenocarcinoma, the optimal threshold was 100 s/mm2, but an optimal subsample could not be identified. Irrespective of the histological subtype, only three b-values were needed for simplified IVIM, but these parameters did not retain their discriminative ability. Conclusion Subsampling of six b-values halved the IVIM scan time without significant losses in accuracy and discriminative ability. Simplified IVIM is possible with only three b-values, at the risk of losing diagnostic information.
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Affiliation(s)
| | | | | | - Mandi Wang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
| | - Anton Sebastian Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Moritz Christoph Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
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Wang H, Zhu L, Li G, Zuo M, Ma X, Wang J. Perfusion parameters of intravoxel incoherent motion based on tumor edge region of interest in cervical cancer: evaluation of differentiation and correlation with dynamic contrast-enhanced MRI. Acta Radiol 2020; 61:1087-1095. [PMID: 31825761 DOI: 10.1177/0284185119890086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) is a functional magnetic resonance imaging (MRI) sequence. PURPOSE To evaluate the value of perfusion parameters derived from IVIM-DWI based on tumor edge region of interest (ROI) in differentiation in cervical cancer and investigate the relationship between IVIM and dynamic contrast-enhanced MRI (DCE-MRI). MATERIAL AND METHODS Thirty-three patients with pathologically diagnosed squamous cell carcinoma who underwent IVIM-DWI (nine b-values: 1-1000 s/mm2) and DCE-MRI were retrospectively assessed in this study. Parameters of IVIM (D, f, D*, fD*) and quantitative parameters of DCE-MRI (Ktrans, Kep, Ve) were derived using tumor edge ROI. Mann-Whitney U test was used to compare parameters between pathological grades and receiver operating characteristic (ROC) curves were used. Pearson's correlation coefficient (r) evaluated the correlation between perfusion parameters derived from IVIM and DCE-MRI. RESULTS The poorly differentiated group showed the significantly lower D value and the higher f, Ktrans and Kep values than the well-to-moderately differentiated group (P < 0.05). ROC curves indicated that f < 26%, Ktrans <0.38/min, and Kep <1.62/min could differentiate the poorly differentiated group from the well-to-moderately differentiated group (AUC 0.753-0.808). Significantly positive correlations were found between f and Ktrans (r = 0.422, P = 0.014) and between fD* and Ktrans (r = 0.448, P = 0.009). CONCLUSION Perfusion parameters derived from IVIM based on tumor edge ROI may offer additional value in differentiation in cervical cancer, and the IVIM perfusion parameters showed moderate positive correlations with quantitative perfusion parameters from DCE-MRI, while f and fD* showed promising significance.
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Affiliation(s)
- Hongyan Wang
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
| | - Lixia Zhu
- Department of Obstetrics and Gynecology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
| | - Guohua Li
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
| | - Menzhe Zuo
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
| | - Xi Ma
- Department of Ultrasound Diagnosis, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
| | - Jianliang Wang
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, PR China
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Long L, Zhang H, He X, Zhou J, Guo D, Liu X. Value of intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic from nonmetastatic mesorectal lymph nodes with different short-axis diameters in rectal cancer. J Cancer Res Ther 2020; 15:1508-1515. [PMID: 31939430 DOI: 10.4103/jcrt.jcrt_76_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Conventional magnetic resonance imaging (MRI) does not accurately evaluate lymph node (LN) status, which is essential for the treatment and prognosis assessment in patients with rectal cancer. Objective The aim of this study is to evaluate the diagnostic value of intravoxel incoherent motion (IVIM) MRI in differentiating metastatic and nonmetastatic mesorectal LNs with different short-axis diameters in rectal cancer patients. Materials and Methods Forty patients (154 LNs) were divided into three groups based on short-axis diameter: 3 mm ≤ × ≤5 mm, 5 mm < × ≤7 mm, and × >7 mm. MRI characteristics and IVIM parameters were compared between the metastatic and nonmetastatic LNs to determine the diagnostic value for discriminating them. Results In the 3 mm ≤ × ≤ 5 mm group, mean D values were significantly lower in metastatic than in the nonmetastatic LNs (P < 0.001). In the 5 mm < × ≤7 mm group, mean f values were significantly lower in metastatic than nonmetastatic LNs (P < 0.05). In the × >7 mm group, only the short-axis diameter of metastatic LNs was significantly greater than that of nonmetastatic LNs (P < 0.05). The area under the curve, sensitivity, specificity, and cutoff values were used for differentiating the metastatic from the nonmetastatic LNs. Conclusion IVIM parameters can differentiate metastatic from nonmetastatic LNs with smaller short-axis diameters (× ≤7 mm) in rectal cancer, and the short-axis diameter is a significant factor in identifying metastatic and nonmetastatic LNs in larger short-axis diameter groups (× >7 mm).
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Affiliation(s)
- Ling Long
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Haiping Zhang
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Xiaojing He
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Jun Zhou
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Dajing Guo
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Xinjie Liu
- Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
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Iima M. Perfusion-driven Intravoxel Incoherent Motion (IVIM) MRI in Oncology: Applications, Challenges, and Future Trends. Magn Reson Med Sci 2020; 20:125-138. [PMID: 32536681 PMCID: PMC8203481 DOI: 10.2463/mrms.rev.2019-0124] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Recent developments in MR hardware and software have allowed a surge of interest in intravoxel incoherent motion (IVIM) MRI in oncology. Beyond diffusion-weighted imaging (and the standard apparent diffusion coefficient mapping most commonly used clinically), IVIM provides information on tissue microcirculation without the need for contrast agents. In oncology, perfusion-driven IVIM MRI has already shown its potential for the differential diagnosis of malignant and benign tumors, as well as for detecting prognostic biomarkers and treatment monitoring. Current developments in IVIM data processing, and its use as a method of scanning patients who cannot receive contrast agents, are expected to increase further utilization. This paper reviews the current applications, challenges, and future trends of perfusion-driven IVIM in oncology.
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Affiliation(s)
- Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.,Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital
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14
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Lund KV, Simonsen TG, Kristensen GB, Rofstad EK. DCE-MRI of locally-advanced carcinoma of the uterine cervix: Tofts analysis versus non-model-based analyses. Radiat Oncol 2020; 15:79. [PMID: 32293487 PMCID: PMC7158049 DOI: 10.1186/s13014-020-01526-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide biomarkers of the outcome of locally-advanced cervical carcinoma (LACC). There is, however, no agreement on how DCE-MR recordings should be analyzed. Previously, we have analyzed DCE-MRI data of LACC using non-model-based strategies. In the current study, we analyzed DCE-MRI data of LACC using the Tofts pharmacokinetic model, and the biomarkers derived from this analysis were compared with those derived from the non-model-based analyses. METHODS Eighty LACC patients given cisplatin-based chemoradiotherapy with curative intent were included in the study. Treatment outcome was recorded as disease-free survival (DFS) and overall survival (OS). DCE-MRI series were analyzed voxelwise to produce Ktrans and ve frequency distributions, and ROC analysis was used to identify the parameters of the frequency distributions having the greatest potential as biomarkers. The prognostic power of these parameters was compared with that of the non-model-based parameters LETV (low-enhancing tumor volume) and TVIS (tumor volume with increasing signal). RESULTS Poor DFS and OS were associated with low values of Ktrans, whereas there was no association between treatment outcome and ve. The Ktrans parameters having the greatest prognostic value were p35-Ktrans (the Ktrans value at the 35 percentile of a frequency distribution) and RV-Ktrans (the tumor subvolume with Ktrans values below 0.13 min- 1). Multivariate analysis including clinical parameters and p35-Ktrans or RV-Ktrans revealed that RV-Ktrans was the only independent prognostic factor of DFS and OS. There were significant correlations between RV-Ktrans and LETV and between RV-Ktrans and TVIS, and the prognostic power of RV-Ktrans was similar to that of LETV and TVIS. CONCLUSIONS Biomarkers of the outcome of LACC can be provided by analyzing DCE-MRI series using the Tofts pharmacokinetic model. However, these biomarkers do not appear to have greater prognostic value than biomarkers determined by non-model-based analyses.
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Affiliation(s)
- Kjersti V Lund
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Trude G Simonsen
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Gunnar B Kristensen
- Department of Gynecological Cancer, Oslo University Hospital, Oslo, Norway.,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Einar K Rofstad
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
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Perucho JAU, Chiu KWH, Wong EMF, Tse KY, Chu MMY, Chan LWC, Pang H, Khong PL, Lee EYP. Diffusion-weighted magnetic resonance imaging of primary cervical cancer in the detection of sub-centimetre metastatic lymph nodes. Cancer Imaging 2020; 20:27. [PMID: 32252829 PMCID: PMC7137185 DOI: 10.1186/s40644-020-00303-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/20/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has limited accuracy in detecting pelvic lymph node (PLN) metastasis. This study aimed to examine the use of intravoxel incoherent motion (IVIM) in classifying pelvic lymph node (PLN) involvement in cervical cancer patients. METHODS Fifty cervical cancer patients with pre-treatment magnetic resonance imaging (MRI) were examined for PLN involvement by one subspecialist and one non-subspecialist radiologist. PLN status was confirmed by positron emission tomography or histology. The tumours were then segmented by both radiologists. Kruskal-Wallis tests were used to test for differences between diffusion tumour volume (DTV), apparent diffusion coefficient (ADC), pure diffusion coefficient (D), and perfusion fraction (f) in patients with no malignant PLN involvement, those with sub-centimetre and size-significant PLN metastases. These parameters were then considered as classifiers for PLN involvement, and were compared with the accuracies of radiologists. RESULTS Twenty-one patients had PLN involvement of which 10 had sub-centimetre metastatic PLNs. DTV increased (p = 0.013) while ADC (p = 0.015), and f (p = 0.006) decreased as the nodal status progressed from no malignant involvement to sub-centimetre and then size-significant PLN metastases. In determining PLN involvement, a classification model (DTV + f) had similar accuracies (80%) as the non-subspecialist (76%; p = 0.73) and subspecialist (90%; p = 0.31). However, in identifying patients with sub-centimetre PLN metastasis, the model had higher accuracy (90%) than the non-subspecialist (30%; p = 0.01) but had similar accuracy with the subspecialist (90%, p = 1.00). Interobserver variability in tumour delineation did not significantly affect the performance of the classification model. CONCLUSION IVIM is useful in determining PLN involvement but the added value decreases with reader experience.
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Affiliation(s)
- Jose Angelo Udal Perucho
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 406, Block K, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Keith Wan Hang Chiu
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 406, Block K, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Esther Man Fung Wong
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong
| | - Ka Yu Tse
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Mandy Man Yee Chu
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Lawrence Wing Chi Chan
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Room Y934, 9/F, Lee Shau Kee Building, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong
| | - Pek-Lan Khong
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 406, Block K, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Elaine Yuen Phin Lee
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 406, Block K, Queen Mary Hospital, Pok Fu Lam Road, Pok Fu Lam, Hong Kong
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Doudou NR, Liu Y, Kampo S, Zhang K, Dai Y, Wang S. Optimization of intravoxel incoherent motion (IVIM): variability of parameters measurements using a reduced distribution of b values for breast tumors analysis. MAGMA (NEW YORK, N.Y.) 2020; 33:273-281. [PMID: 31571014 DOI: 10.1007/s10334-019-00779-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study aimed to examine the variability of intravoxel incoherent motion measurements acquired from reduced distributions of b values for breast tumors analysis. MATERIALS AND METHODS The investigations were carried out on twenty-four patients with diagnosed breast tumors. A conventional unenhanced MRI and various IVIM series preset with different distributions of b values (0-1000 s/mm2) were performed. We assessed the variability in Dslow, Dfast, and PF measurements for different distributions of 9 to 4 b values compared with the IVIM metrics for 10 b values using Wilcoxon-Signed rank test. The data was statistically significant at P < 0.05. RESULTS The results showed no significant variation in the estimations of IVIM parameters in patients. However, the measurements acquired with the combination of 5 b values Showed some variation in Dfast (P = 0.028) compared with 10 b values. The data showed high wCVs in the measurements acquired using the reduced set of 6 b values for Dslow and PF and with the combination of 7 b values for Dfast. There were inconsistencies noticed in the measurements acquired from malignant tumors using reduced distributions of b values (9 b values-4 b values). However, the set of 4 b values displayed the lowest wCVs for both benign and malignant datasets. We also observed unsystematic correlations among different combinations of b values in the categories of IVIM parameters. CONCLUSION There was no relevant variation in the parameters measurements irrespective of the number of b values used. Reduced distributions of b values may find use in estimations of IVIM parameters for breast lesions analysis.
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Affiliation(s)
- Natacha Raissa Doudou
- Department of Radiology, Dalian Medical University, Dalian, China
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yajie Liu
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sylvanus Kampo
- Department of Anesthesiology, Dalian Medical University, Dalian, China
| | - Kai Zhang
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yue Dai
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shaowu Wang
- Department of Radiology, Dalian Medical University, Dalian, China.
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
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Ogura A, Sotome H, Asai A, Fuju A. Evaluation of capillary blood volume in the lower limb muscles after exercise by intravoxel incoherent motion. Radiol Med 2020; 125:474-480. [DOI: 10.1007/s11547-020-01163-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/02/2020] [Indexed: 12/22/2022]
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Sun H, Xu Y, Xu Q, Duan J, Zhang H, Liu T, Li L, Chan Q, Xie S, Wang W. Correlation Between Intravoxel Incoherent Motion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Parameters in Rectal Cancer. Acad Radiol 2019; 26:e134-e140. [PMID: 30268719 DOI: 10.1016/j.acra.2018.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 12/22/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to determine the correlation between intravoxel incoherent motion (IVIM) and multiphase dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in patients with rectal cancer. MATERIALS AND METHODS Ninety-seven patients with rectal cancer were included in this study. All pelvic MRI examinations were performed in a 3.0 T MR unit, including diffusion-weighted imaging with 16 b values, DCE-MRI with two different flip angles (5° and 10°, respectively), and T1-fast field echo sequences as the reference. The IVIM perfusion-related parameters (f, perfusion fraction; D*, pseudo-diffusion coefficient; f·D*, the multiplication of the two parameters) were calculated by biexponential analysis. Quantitative DCE-MRI parameters were transfer constant (Ktrans) between blood plasma and extravascular extracellular space), Kep (rate between extravascular extracellular space and blood plasma), Ve (extravascular volume fraction), Vp (plasma volume fraction), and area under the gadolinium concentration curve. Interobserver agreements were evaluated using the intraclass correlation coefficient and Bland-Altman analysis. A p value <0.05 indicated a statistically significant difference. RESULTS The study included 75 males and 22 females with a median age of 58.8 years (range, 26-85years). Interobserver reproducibility for IVIM perfusion-related parameters and DCE-MRI quantitative parameters was good to excellent (intraclass correlation coefficient = 0.8618-0.9181, intraclass correlation coefficient = 0.7826-0.9088, respectively). Moderate correlations were found between f·D* and Ktrans (r = 0.533; p < 0.001), and relatively weak correlations between D* and Ktrans (r = 0.389; p < 0.001), D* and Vp (r = 0.442; p < 0.001), f·D* and Vp (r = 0.466; p < 0.001), and f and Vp (r = -0.234; p = 0.021). CONCLUSION IVIM perfusion-related parameters, especially f·D*, demonstrated moderate correlations with DCE-MRI quantitative parameters in rectal cancer.
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Affiliation(s)
- Hongliang Sun
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China.
| | - Yanyan Xu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Qiaoyu Xu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Jianghui Duan
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Haibo Zhang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Tongxi Liu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Lu Li
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Queenie Chan
- Philips Healthcare, Shatin, New Territories, Hong Kong, China
| | - Sheng Xie
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
| | - Wu Wang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China
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Yang X, Xiao X, Lu B, Chen Y, Wen Z, Yu S. Perfusion-sensitive parameters of intravoxel incoherent motion MRI in rectal cancer: evaluation of reproducibility and correlation with dynamic contrast-enhanced MRI. Acta Radiol 2019; 60:569-577. [PMID: 30114928 DOI: 10.1177/0284185118791201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) acquires tumor perfusion information without injection of contrast medium, which is promising in tumor assessment. However, its consistency with dynamic contrast-enhanced MRI (DCE-MRI), a more widely used method for tumor perfusion evaluation, is not revealed in rectal cancer. PURPOSE In this study, we aimed to investigate the correlation of perfusion-sensitive parameters derived from IVIM-MRI with DCE-MRI and measurement reproducibility of IVIM-MRI parameters in rectal cancer. MATERIAL AND METHODS Forty-seven rectal cancer patients underwent IVIM-MRI with 16 b-values and DCE-MRI. The perfusion fraction ( f), pseudo-diffusion coefficient ( D*), and f· D* were measured by two radiologists independently and correlated with the transfer constant ( Ktrans), reflux constant ( kep), and extravascular extracellular fractional volume ( ve) obtained from DCE-MRI. RESULTS Pearson's correlation analyses of IVIM-MRI and DCE-MRI parameters showed fair to moderate correlation between f and Ktrans ( r = 0.461, P = 0.001), followed by f and kep ( r = 0.430, P = 0.003), f·D*, and Ktrans ( r = 0.425, P = 0.003), f·D*, and kep ( r = 0.384, P = 0.008). There was no significant correlation between ve and f, ve and D*, ve and f· D*, D* and Ktrans, and D* and kep. The reproducibility of IVIM-MRI measurements was moderate. For parameter f, intraclass correlation coefficient (ICC) = 0.71 (0.53-0.82), coefficient of variation (CV) = 13.05 ± 0.02%, limit of agreement (LoA) = -0.05-0.04; for parameter D*, ICC = 0.55 (0.32-0.72), CV = 20.28 ± 3.23%, LoA = -9.6-8.4. CONCLUSION Perfusion-sensitive parameters derived from IVIM-MRI correlated fairly to moderately with DCE-MRI in rectal cancer patients and showed moderate measurement reproducibility. IVIM-MRI supplements routine high-resolution MRI without contrast enhancement to provide information of tumor microcirculation.
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Affiliation(s)
- Xinyue Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Xiaojuan Xiao
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Baolan Lu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Ziqiang Wen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Shenping Yu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
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Du S, Sun H, Gao S, Xin J, Lu Z, Chen Z, Pan S, Guo Q. Relationship between 18F-FDG PET metabolic parameters and MRI intravoxel incoherent motion (IVIM) histogram parameters and their correlations with clinicopathological features of cervical cancer: evidence from integrated PET/MRI. Clin Radiol 2019; 74:178-186. [DOI: 10.1016/j.crad.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/09/2018] [Indexed: 12/14/2022]
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Li X, Wu S, Li D, Yu T, Zhu H, Song Y, Meng L, Fan H, Xie L. Intravoxel Incoherent Motion Combined With Dynamic Contrast-Enhanced Perfusion MRI of Early Cervical Carcinoma: Correlations Between Multimodal Parameters and HIF-1α Expression. J Magn Reson Imaging 2019; 50:918-929. [PMID: 30648775 DOI: 10.1002/jmri.26604] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Xiangsheng Li
- Department of Radiology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Shandong Wu
- Imaging Research Division Department of Radiology, Biomedical Informatics, and Bioengineering; University of Pittsburgh; Pittsburgh Pennsylvania USA
| | - Dechang Li
- Department of Pathology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Tao Yu
- Department of Medical Imaging; Cancer Hospital of China Medical University; Liaoning Cancer Hospital & Institute; Shenyang Liaoning Province China
| | - Hongxian Zhu
- Department of Radiology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Yunlong Song
- Department of Radiology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Limin Meng
- Department of Radiology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Hongxia Fan
- Department of Radiology; Air Force General Hospital, People's Liberation Army; Beijing China
| | - Lizhi Xie
- Department of MR Research; GE Healthcare; Beijing China
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Investigating the correlation of arterial spin labeling and dynamic contrast enhanced perfusion in primary tumor of nasopharyngeal carcinoma. Eur J Radiol 2018; 108:222-229. [DOI: 10.1016/j.ejrad.2018.09.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/11/2022]
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Leibfarth S, Winter RM, Lyng H, Zips D, Thorwarth D. Potentials and challenges of diffusion-weighted magnetic resonance imaging in radiotherapy. Clin Transl Radiat Oncol 2018; 13:29-37. [PMID: 30294681 PMCID: PMC6169338 DOI: 10.1016/j.ctro.2018.09.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/20/2018] [Accepted: 09/03/2018] [Indexed: 02/09/2023] Open
Abstract
Discussion of DW imaging protocols and imaging setup. Discussion of mono- and bi-exponential models for quantitative parameter extraction. Review of recent publications investigating potential benefits of using DWI in RT, including detailed synoptic table. Detailed discussion of geometric and quantitative accuracy of DW imaging and DW-derived parameters.
Purpose To review the potential and challenges of integrating diffusion weighted magnetic resonance imaging (DWI) into radiotherapy (RT). Content Details related to image acquisition of DWI for RT purposes are discussed, along with the challenges with respect to geometric accuracy and the robustness of quantitative parameter extraction. An overview of diffusion- and perfusion-related parameters derived from mono- and bi-exponential models is provided, and their role as potential RT biomarkers is discussed. Recent studies demonstrating potential of DWI in different tumor sites such as the head and neck, rectum, cervix, prostate, and brain, are reviewed in detail. Conclusion DWI has shown promise for RT outcome prediction, response assessment, as well as for tumor delineation and characterization in several cancer types. Geometric and quantification robustness is challenging and has to be addressed adequately. Evaluation in larger clinical trials with well designed imaging protocol and advanced analysis models is needed to develop the optimal strategy for integrating DWI in RT.
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Affiliation(s)
- Sara Leibfarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - René M Winter
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - Heidi Lyng
- Department of Radiation Biology, Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - Daniel Zips
- Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - Daniela Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
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Dregely I, Prezzi D, Kelly‐Morland C, Roccia E, Neji R, Goh V. Imaging biomarkers in oncology: Basics and application to MRI. J Magn Reson Imaging 2018; 48:13-26. [PMID: 29969192 PMCID: PMC6587121 DOI: 10.1002/jmri.26058] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer remains a global killer alongside cardiovascular disease. A better understanding of cancer biology has transformed its management with an increasing emphasis on a personalized approach, so-called "precision cancer medicine." Imaging has a key role to play in the management of cancer patients. Imaging biomarkers that objectively inform on tumor biology, the tumor environment, and tumor changes in response to an intervention complement genomic and molecular diagnostics. In this review we describe the key principles for imaging biomarker development and discuss the current status with respect to magnetic resonance imaging (MRI). LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 5 J. Magn. Reson. Imaging 2018;48:13-26.
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Affiliation(s)
- Isabel Dregely
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Davide Prezzi
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Christian Kelly‐Morland
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Elisa Roccia
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Radhouene Neji
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
- MR Research CollaborationsSiemens HealthcareFrimleyUK
| | - Vicky Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
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Sotome H, Ogura A, Asai A, Fuju A. [Capillary Blood Flow of Muscle Before and After the Exercise Used by Intravoxel Incoherent Motion]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:861-868. [PMID: 30232311 DOI: 10.6009/jjrt.2018_jsrt_74.9.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Capillaries are the most basic and important blood vessel of the circulatory systems. The evaluation of the blood flow may contribute to many studies in future. We evaluated the capillary blood flow change of lower limb muscle over time before and after the exercise used by magnetic resonance imaging-intravoxel incoherent motion (MRI-IVIM) obtained perfusion information. Furthermore, we examined an association between the muscle pain after the exercise and the diffusion weighted image (DWI) indexes. DWI was imaged using multi-b values for a thigh and calf muscles. MRI was performed just after an exercise test, 3, 6, and 24 hours later, and the IVIM index and diffusion index were calculated. Furthermore, we interviewed the degree of the muscle ache 24 hours later. As a result, pseudo diffusion coefficient (D*) and f value as IVIM index increased after-exercise as compared with pre-exercise and decreased in 3 hours later. A similar tendency was found in the apparent diffusion coefficient and the diffusion coefficient as diffusion index. Furthermore, all indexes increased in after exercise from before exercise and decreased with time passed and increased again 24 hours later. In conclusion, IVIM could obtain capillary blood flow information, and it was suggested to contribute for sports medicine in future.
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Affiliation(s)
- Hana Sotome
- School of Radiological Technology, Gunma Prefectural College of Health Sciences (Current address: Department of Radiology, Fujioka General Hospital)
| | - Akio Ogura
- Graduate School, Gunma Prefectural College of Health Sciences
| | - Ayumi Asai
- School of Radiological Technology, Gunma Prefectural College of Health Sciences (Current address: Department of Radiology, Shizuoka City Shizuoka Hospital)
| | - Atsuya Fuju
- School of Radiological Technology, Gunma Prefectural College of Health Sciences (Current address: Department of Radiology, Kiryu Kosei General Hospital)
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Assessment of Correlation between Intravoxel Incoherent Motion Diffusion Weighted MR Imaging and Dynamic Contrast-Enhanced MR Imaging of Sacroiliitis with Ankylosing Spondylitis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8135863. [PMID: 29445743 PMCID: PMC5763214 DOI: 10.1155/2017/8135863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/07/2017] [Accepted: 12/03/2017] [Indexed: 12/18/2022]
Abstract
The relationships between IVIM and DCE-MRI parameters in AS are not clear. We explore the correlation between intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE) parameters obtained on MR images in patients with ankylosing spondylitis (AS). Forty-four patients with AS were prospectively examined using a 1.5-T MR system. IVIM DWI was performed with 11 b values (range, 0–800 s/mm2) for all patients. The correlation coefficients between IVIM and DCE-MRI parameters were analyzed using Spearman's method. Our results showed that intra- and interobserver reproducibility were excellent to relatively good (ICC = 0.804–0.981; narrow width of 95% limits of agreement). Moderate positive correlations were observed between pure molecular diffusion (Ds) and maximum enhancement (ME) and relative enhancement (RE) (r = 0.700, P < 0.001; r = 0.607, P < 0.001, resp.). Perfusion-related diffusion (Df) showed negative moderate correlation with ME (r = −0.608, P < 0.001). However, no correlation was observed between perfusion fraction (f) and any parameters of ME, RE, TTP, and BE (r = −0.093–0.213; P > 0.165). In conclusion, the IVIM parameters, especially f, might play a critical role in detecting the progression of AS, because it can provide more perfusion information compared with DCE-MRI; besides the IVIM MRI is a noninvasive method.
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Federau C. Intravoxel incoherent motion MRI as a means to measure in vivo perfusion: A review of the evidence. NMR IN BIOMEDICINE 2017; 30. [PMID: 28885745 DOI: 10.1002/nbm.3780] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/19/2017] [Accepted: 07/07/2017] [Indexed: 05/07/2023]
Abstract
The idea that in vivo intravoxel incoherent motion magnetic resonance signal is influenced by blood motion in the microvasculature is exciting, because it suggests that local and quantitative perfusion information can be obtained in a simple and elegant way from a few diffusion-weighted images, without contrast injection. When the method was proposed in the late 1980s some doubts appeared as to its feasibility, and, probably because the signal to noise and image quality at the time was not sufficient, no obvious experimental evidence could be produced to alleviate them. Helped by the tremendous improvements seen in the last three decades in MR hardware, pulse design, and post-processing capabilities, an increasing number of encouraging reports on the value of intravoxel incoherent motion perfusion imaging have emerged. The aim of this article is to review the current published evidence on the feasibility of in vivo perfusion imaging with intravoxel incoherent motion MRI.
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Affiliation(s)
- Christian Federau
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben, Basle, Switzerland
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Becker AS, Ghafoor S, Marcon M, Perucho JA, Wurnig MC, Wagner MW, Khong PL, Lee EY, Boss A. MRI texture features may predict differentiation and nodal stage of cervical cancer: a pilot study. Acta Radiol Open 2017; 6:2058460117729574. [PMID: 29085671 PMCID: PMC5648100 DOI: 10.1177/2058460117729574] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 12/23/2022] Open
Abstract
Background Texture analysis in oncological magnetic resonance imaging (MRI) may yield surrogate markers for tumor differentiation and staging, both of which are important factors in the treatment planning for cervical cancer. Purpose To identify texture features which may predict tumor differentiation and nodal status in diffusion-weighted imaging (DWI) of cervical carcinoma Material and Methods Twenty-three patients were enrolled in this prospective, institutional review board (IRB)-approved study. Pelvic MRI was performed at 3-T including a DWI echo-planar sequence with b-values 40, 300, and 800 s/mm2. Apparent diffusion coefficient (ADC) maps were used for region of interest (ROI)-based texture analysis (32 texture features) of tumor, muscle, and fat based on histogram and gray-level matrices (GLM). All features confounded by the ROI size (linear model) were excluded. The remaining features were examined for correlations with histological differentiation (Spearman) and nodal status (Kruskal–Wallis). Hierarchical cluster analysis was used to identify correlations between features. A P value < 0.05 was considered statistically significant. Results Mean age was 55 years (range = 37–78 years). Biopsy revealed two well-differentiated, eight moderately differentiated, two moderately to poorly differentiated tumors, and five poorly differentiated tumors. Six tumors could not be graded. Lymph nodes were involved in 11 patients. Three GLM features correlated with the differentiation: LRHGE (ϱ = 0.53, P = 0.03), ZP (ϱ = –0.49, P < 0.05), and SZE (ϱ = –0.51, P = 0.04). Two histogram features, skewness (0.65 vs. 1.08, P = 0.04) and kurtosis (0.53 vs. 1.67, P = 0.02), were higher in patients with positive nodal status. Cluster analysis revealed several co-correlations. Conclusion We identified potentially predictive GLM features for histological tumor differentiation and histogram features for nodal cancer stage.
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Affiliation(s)
- Anton S Becker
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
| | - Soleen Ghafoor
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
| | - Magda Marcon
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
| | - Jose A Perucho
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, PR China
| | - Moritz C Wurnig
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
| | - Matthias W Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
| | - Pek-Lan Khong
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, PR China
| | - Elaine Yp Lee
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, PR China
| | - Andreas Boss
- Department of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich, Switzerland
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Dappa E, Elger T, Hasenburg A, Düber C, Battista MJ, Hötker AM. The value of advanced MRI techniques in the assessment of cervical cancer: a review. Insights Imaging 2017; 8:471-481. [PMID: 28828723 PMCID: PMC5621992 DOI: 10.1007/s13244-017-0567-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To assess the value of new magnetic resonance imaging (MRI) techniques in cervical cancer. METHODS We searched PubMed and MEDLINE and reviewed articles published from 1990 to 2016 to identify studies that used MRI techniques, such as diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and dynamic contrast enhancement (DCE) MRI, to assess parametric invasion, to detect lymph node metastases, tumour subtype and grading, and to detect and predict tumour recurrence. RESULTS Seventy-nine studies were included. The additional use of DWI improved the accuracy and sensitivity of the evaluation of parametrial extension. Most studies reported improved detection of nodal metastases. Functional MRI techniques have the potential to assess tumour subtypes and tumour grade differentiation, and they showed additional value in detecting and predicting treatment response. Limitations included a lack of technical standardisation, which limits reproducibility. CONCLUSIONS New advanced MRI techniques allow improved analysis of tumour biology and the tumour microenvironment. They can improve TNM staging and show promise for tumour classification and for assessing the risk of tumour recurrence. They may be helpful for developing optimised and personalised therapy for patients with cervical cancer. TEACHING POINTS • Conventional MRI plays a key role in the evaluation of cervical cancer. • DWI improves tumour delineation and detection of nodal metastases in cervical cancer. • Advanced MRI techniques show promise regarding histological grading and subtype differentiation. • Tumour ADC is a potential biomarker for response to treatment.
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Affiliation(s)
- Evelyn Dappa
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Tania Elger
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Annette Hasenburg
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marco J Battista
- Department of Gynaecology and Obstetrics, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Andreas M Hötker
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Langenbeckstr. 1, 55131, Mainz, Germany
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Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging of Cervical Cancer With Different b-Values. J Comput Assist Tomogr 2017; 41:592-598. [PMID: 27997440 DOI: 10.1097/rct.0000000000000569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate the dependence of diffusion parameters on the b values adopted for intravoxel incoherent motion diffusion-weighted magnetic resonance imaging and to investigate the application value of multiple diffusion parameters obtained from monoexponential and biexponential models in subjects with a normal cervix and in cervical cancer patients. METHODS A total of 120 female patients with cervical cancer and 21 female control subjects with a normal cervix underwent diffusion-weighted magnetic resonance imaging with 13 b values (0-2000 s/mm) at 3 T. The standard apparent diffusion coefficient (Dst), diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were calculated by fitting with monoexponential and biexponential models at 2 different ranges of b values: 0 to 1000 and 0 to 2000 s/mm. A univariate analysis was performed to identify factors that could distinguish cervical carcinoma from normal cervical tissue. Parameters that correlated with the pathological grade and stage of cervical cancer were also evaluated. Receiver operating characteristic curves were used to evaluate the diagnostic efficiency of every parameter. RESULTS All the tested parameters, except the D* of the 2 different ranges of b value groups, significantly differed between the patients with cervical carcinoma and control subjects (P < 0.01). D2000, Dst2000, and D1000 showed comparable diagnostic value, with an area under the curve of 0.923, 0.909, and 0.907, respectively. Dst2000, D2000, Dst1000, and D1000 differed significantly among the 3 degrees of cervical stromal infiltration depth (P < 0.05). CONCLUSIONS D2000 and Dst2000 tended to outperform D1000 in terms of diagnostic efficiency, but there was no significant difference in their ability to differentiate cervical carcinoma from normal cervix. Cervical cancers with lower Dst and D values tended to have greater infiltration depth.
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Intravoxel Incoherent Motion Diffusion for Identification of Breast Malignant and Benign Tumors Using Chemometrics. BIOMED RESEARCH INTERNATIONAL 2017. [PMID: 28630864 PMCID: PMC5467388 DOI: 10.1155/2017/3845409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the paper is to identify the breast malignant and benign lesions using the features of apparent diffusion coefficient (ADC), perfusion fraction f, pseudodiffusion coefficient D⁎, and true diffusion coefficient D from intravoxel incoherent motion (IVIM). There are 69 malignant cases (including 9 early malignant cases) and 35 benign breast cases who underwent diffusion-weighted MRI at 3.0 T with 8 b-values (0~1000 s/mm2). ADC and IVIM parameters were determined in lesions. The early malignant cases are used as advanced malignant and benign tumors, respectively, so as to assess the effectiveness on the result. A predictive model was constructed using Support Vector Machine Binary Classification (SVMBC, also known Support Vector Machine Discriminant Analysis (SVMDA)) and Partial Least Squares Discriminant Analysis (PLSDA) and compared the difference between them both. The D value and ADC provide accurate identification of malignant lesions with b = 300, if early malignant tumor was considered as advanced malignant (cancer). The classification accuracy is 93.5% for cross-validation using SVMBC with ADC and tissue diffusivity only. The sensitivity and specificity are 100% and 87.0%, respectively, r2cv = 0.8163, and root mean square error of cross-validation (RMSECV) is 0.043. ADC and IVIM provide quantitative measurement of tissue diffusivity for cellularity and are helpful with the method of SVMBC, getting comprehensive and complementary information for differentiation between benign and malignant breast lesions.
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Lu P, Sha Y, Wan H, Wang F, Tian G, Tang W. Assessment of nonarteritic anterior ischemic optic neuropathy with intravoxel incoherent motion diffusion-weighted imaging using readout-segmented echo-planar imaging, parallel imaging, and 2D navigator-based reacquisition. J Magn Reson Imaging 2017; 46:1760-1766. [PMID: 28513892 DOI: 10.1002/jmri.25760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/18/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Ping Lu
- Shanghai Institution of Medical Imaging; Zhongshan Hospital, Fudan University; Shanghai P.R. China
- Department of Radiology; Eye & ENT Hospital of Fudan University; Shanghai P.R. China
| | - Yan Sha
- Department of Radiology; Eye & ENT Hospital of Fudan University; Shanghai P.R. China
| | - Hailin Wan
- Department of Radiology; Eye & ENT Hospital of Fudan University; Shanghai P.R. China
| | - Feng Wang
- Department of Radiology; Eye & ENT Hospital of Fudan University; Shanghai P.R. China
| | - Guohong Tian
- Department of Ophthalmology; Eye & ENT Hospital of Fudan University; Shanghai P.R. China
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Assessment of the link between quantitative biexponential diffusion-weighted imaging and contrast-enhanced MRI in the liver. Magn Reson Imaging 2017; 38:47-53. [DOI: 10.1016/j.mri.2016.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 11/18/2022]
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Hilbert F, Holl-Wieden A, Sauer A, Köstler H, Neubauer H. Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis. Pediatr Radiol 2017; 47:681-690. [PMID: 28283723 DOI: 10.1007/s00247-017-3800-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/30/2016] [Accepted: 02/10/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. OBJECTIVE To investigate the feasibility and diagnostic accuracy of diffusion-weighted MRI with intravoxel incoherent motion (IVIM) for diagnosing synovitis in the knee joint of children with juvenile idiopathic arthritis. MATERIALS AND METHODS Twelve consecutive children with confirmed or suspected juvenile idiopathic arthritis (10 girls, median age 11 years) underwent MRI with contrast-enhanced T1-weighted imaging and DWI at 1.5 T. Read-out segmented multi-shot DWI was acquired at b values of 0 s/mm2, 200 s/mm2, 400 s/mm2 and 800 s/mm2. We calculated the IVIM parameters perfusion fraction (f) and tissue diffusion coefficient (D). Diffusion-weighted images at b=800 s/mm2, f parameter maps and post-contrast T1-weighted images were retrospectively assessed by two independent readers for synovitis using the Juvenile Arthritis MRI Scoring system. RESULTS Seven (58%) children showed synovial hypertrophy on contrast-enhanced imaging. Diagnostic ratings for synovitis on DWI and on f maps were fully consistent with contrast-enhanced imaging, the diagnostic reference. Two children had equivocal low-confidence assessments on DWI. Median f was 6.7±2.0% for synovitis, 2.1±1.2% for effusion, 5.0±1.0% for muscle and 10.6±5.7% for popliteal lymph nodes. Diagnostic confidence was higher based on f maps in three (25%) children and lower in one child (8%), as compared to DWI. CONCLUSION DWI with IVIM reliably visualises synovitis of the knee joint. Perfusion fraction maps differentiate thickened synovium from joint effusion and hence increase diagnostic confidence.
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Affiliation(s)
- Fabian Hilbert
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Annette Holl-Wieden
- Department of Paediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Alexander Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Henning Neubauer
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany. .,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
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Becker AS, Perucho JA, Wurnig MC, Boss A, Ghafoor S, Khong PL, Lee EYP. Assessment of Cervical Cancer with a Parameter-Free Intravoxel Incoherent Motion Imaging Algorithm. Korean J Radiol 2017; 18:510-518. [PMID: 28458603 PMCID: PMC5390620 DOI: 10.3348/kjr.2017.18.3.510] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/13/2016] [Indexed: 12/20/2022] Open
Abstract
Objective To evaluate the feasibility of a parameter-free intravoxel incoherent motion (IVIM) approach in cervical cancer, to assess the optimal b-value threshold, and to preliminarily examine differences in the derived perfusion and diffusion parameters for different histological cancer types. Materials and Methods After Institutional Review Board approval, 19 female patients (mean age, 54 years; age range, 37–78 years) gave consent and were enrolled in this prospective magnetic resonance imaging study. Clinical staging and biopsy results were obtained. Echo-planar diffusion weighted sequences at 13 b-values were acquired at 3 tesla field strength. Single-sliced region-of-interest IVIM analysis with adaptive b-value thresholds was applied to each tumor, yielding the optimal fit and the optimal parameters for pseudodiffusion (D*), perfusion fraction (Fp) and diffusion coefficient (D). Monoexponential apparent diffusion coefficient (ADC) was calculated for comparison with D. Results Biopsy revealed squamous cell carcinoma in 10 patients and adenocarcinoma in 9. The b-value threshold (median [interquartile range]) depended on the histological type and was 35 (22.5–50) s/mm2 in squamous cell carcinoma and 150 (100–150) s/mm2 in adenocarcinoma (p < 0.05). Comparing squamous cell vs. adenocarcinoma, D* (45.1 [25.1–60.4] × 10−3 mm2/s vs. 12.4 [10.5–21.2] × 10−3 mm2/s) and Fp (7.5% [7.0–9.0%] vs. 9.9% [9.0–11.4%]) differed significantly between the subtypes (p < 0.02), whereas D did not (0.89 [0.75–0.94] × 10−3 mm2/s vs. 0.90 [0.82–0.97] × 10−3 mm2/s, p = 0.27). The residuals did not differ (0.74 [0.60–0.92] vs. 0.94 [0.67–1.01], p = 0.32). The ADC systematically underestimated the magnitude of diffusion restriction compared to D (p < 0.001). Conclusion The parameter-free IVIM approach is feasible in cervical cancer. The b-value threshold and perfusion-related parameters depend on the tumor histology type.
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Affiliation(s)
- Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich 8091, Switzerland
| | - Jose A Perucho
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Moritz C Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich 8091, Switzerland
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich 8091, Switzerland
| | - Soleen Ghafoor
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich 8091, Switzerland
| | - Pek-Lan Khong
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Elaine Y P Lee
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
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Marzi S, Piludu F, Forina C, Sanguineti G, Covello R, Spriano G, Vidiri A. Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes. Magn Reson Imaging 2017; 37:1-8. [DOI: 10.1016/j.mri.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
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Lee EYP, Perucho JAU, Vardhanabhuti V, He J, Siu SWK, Ngu SF, Mayr NA, Yuh WTC, Chan Q, Khong PL. Intravoxel incoherent motion MRI assessment of chemoradiation-induced pelvic bone marrow changes in cervical cancer and correlation with hematological toxicity. J Magn Reson Imaging 2017; 46:1491-1498. [PMID: 28225579 DOI: 10.1002/jmri.25680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/06/2017] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate bone marrow changes after chemoradiation (CRT) using intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) and correlate imaging changes with hematological toxicity (HT) in patients with locally advanced cervical cancer. MATERIALS AND METHODS Thirty-nine patients with newly diagnosed cervical cancer were prospectively recruited for two sequential 3.0T IVIM-MRI studies: before treatment (MRI-1) and 3-4 weeks after standardized CRT (MRI-2). The irradiated pelvic bone marrow was outlined as the regions of interest to derive the true diffusion coefficient (D) and perfusion fraction (f) based on a biexponential model. The apparent coefficient diffusion (ADC) was derived using the monoexponential model. Changes in these parameters between MRI-1 and MRI-2 were calculated as ΔD, Δf, and ΔADC. HT was defined accordingly to NCI-CTCAE (v. 4.03) of grade 3 and above. Statistical analysis was performed using Mann-Whitney U-test. RESULTS The median age of patients was 54 years old (range 27-83 years old); 14 patients suffered from HT. Early bone marrow changes (3-4 weeks) of ΔD showed a significant difference between HT and non-HT groups (6.4 ± 19.7% vs. -6.4 ± 19.4%, respectively, P = 0.041). However, no significant changes were noted in Δf (3.7 ± 13.3% vs. 1.5 ± 12.5% respectively, P = 0. 592) and ΔADC (5.5 ± 26.3% vs. -3.3 ± 27.0% respectively, P = 0.303) between the HT and non-HT groups. Δf increased insignificantly for both groups. CONCLUSION ΔD was the only significant parameter to differentiate early cellular environment changes in bone marrow after CRT, suggestive that ΔD was more sensitive than Δf and ΔADC to reflect the underlying microenvironment injury. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1491-1498.
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Affiliation(s)
- Elaine Yuen Phin Lee
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | | | - Vince Vardhanabhuti
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, P.R. China
| | | | - Siew Fei Ngu
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - William T C Yuh
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | | | - Pek-Lan Khong
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
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Keil VC, Mädler B, Gielen GH, Pintea B, Hiththetiya K, Gaspranova AR, Gieseke J, Simon M, Schild HH, Hadizadeh DR. Intravoxel incoherent motion MRI in the brain: Impact of the fitting model on perfusion fraction and lesion differentiability. J Magn Reson Imaging 2017; 46:1187-1199. [PMID: 28152250 DOI: 10.1002/jmri.25615] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/13/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate the effect of the choice of the curve-fitting model on the perfusion fraction (fIVIM ) with regard to tissue type characterization, correlation with microvascular anatomy, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters. Several curve-fitting models coexist in intravoxel incoherent motion (IVIM) MRI to derive the (fIVIM ). MATERIALS AND METHODS In all, 29 patients with brain lesions (12 gliomas, 11 meningiomas, three metastases, two gliotic scars, one multiple sclerosis) underwent IVIM-MRI (32 b-values, 0 to 2000 s/mm2 ) at 3T. fIVIM was determined by classic monoexponential, biexponential, and a novel nonnegative least squares (NNLS) fitting in 352 regions of interest (lesion-containing and normal-appearing tissue) and tested their correlation with DCE-MRI kinetic parameters and microvascular anatomy derived from 57 region of interest (ROI)-based biopsies and their capacities to differentiate histologically different lesions. RESULTS fIVIM differed significantly between all three models and all tissue types (monoexponential confidence interval in percent [CI 3.4-3.8]; biexponential [CI 11.21-12.45]; NNLS [CI 2.06-2.60]; all P < 0.001). For all models an increase in fIVIM was associated with a shift to larger vessels and higher vessel area / tissue area ratio (regression coefficient 0.07-0.52; P = 0.04-0.001). Correlation with kinetic parameters derived from DCE-MRI was usually not significant. Only biexponential fitting allowed differentiation of both gliosis from edema and high- from low-grade glioma (both P < 0.001). CONCLUSION The curve-fitting model has an important impact on fIVIM and its capacity to differentiate tissues. fIVIM may possibly be used to assess microvascular anatomy and is weakly correlated with DCE-MRI kinetic parameters. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1187-1199.
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Affiliation(s)
- Vera C Keil
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Gerrit H Gielen
- University Hospital Bonn/Germany, Department of Neuropathology, Center for Pathology, Bonn, Germany
| | - Bogdan Pintea
- BG Krankenhaus Bergmannsheil, Bochum/Germany, Bochum, Germany
| | | | - Alisa R Gaspranova
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Matthias Simon
- Ev. Krankenhaus Bielefeld/Germany, Department of Neurosurgery, Bielefeld, Germany.,University Hospital Bonn/Germany, Department of Neurosurgery and Stereotaxy, Bonn, Germany
| | - Hans H Schild
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
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Lyng H, Malinen E. Hypoxia in cervical cancer: from biology to imaging. Clin Transl Imaging 2017; 5:373-388. [PMID: 28804704 PMCID: PMC5532411 DOI: 10.1007/s40336-017-0238-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/24/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Hypoxia imaging may improve identification of cervical cancer patients at risk of treatment failure and be utilized in treatment planning and monitoring, but its clinical potential is far from fully realized. Here, we briefly describe the biology of hypoxia in cervix tumors of relevance for imaging, and evaluate positron emission tomography (PET) and magnetic resonance imaging (MRI) techniques that have shown promise for assessing hypoxia in a clinical setting. We further discuss emerging imaging approaches, and how imaging can play a role in future treatment strategies to target hypoxia. METHODS We performed a PubMed literature search, using keywords related to imaging and hypoxia in cervical cancer, with a particular emphasis on studies correlating imaging with other hypoxia measures and treatment outcome. RESULTS Only a few and rather small studies have utilized PET with tracers specific for hypoxia, and no firm conclusions regarding preferred tracer or clinical potential can be drawn so far. Most studies address indirect hypoxia imaging with dynamic contrast-enhanced techniques. Strong evidences for a role of these techniques in hypoxia imaging have been presented. Pre-treatment images have shown significant association to outcome in several studies, and images acquired during fractionated radiotherapy may further improve risk stratification. Multiparametric MRI and multimodality PET/MRI enable combined imaging of factors of relevance for tumor hypoxia and warrant further investigation. CONCLUSIONS Several imaging approaches have shown promise for hypoxia imaging in cervical cancer. Evaluation in large clinical trials is required to decide upon the optimal modality and approach.
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Affiliation(s)
- Heidi Lyng
- Department of Radiation Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Eirik Malinen
- Department of Medical Physics, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Department of Physics, University of Oslo, Oslo, Norway
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40
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Park SB. Functional MR imaging in gynecologic malignancies: current status and future perspectives. Abdom Radiol (NY) 2016; 41:2509-2523. [PMID: 27743019 DOI: 10.1007/s00261-016-0924-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Using functional MR imaging techniques, we can approach the functional assessment of gynecologic malignancies. Among them, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MR imaging (DCE-MRI) are two important techniques. This article provides an overview of functional MR imaging techniques, focusing DWI and DCE-MRI on clinical application in gynecologic malignancies. Functional MR imaging techniques play an important role in detection, characterization, staging, treatment response, and outcome prediction, as well as providing conventional morphologic imaging. Familiarity with the characteristics and imaging features of functional MR imaging in gynecologic malignancies will facilitate prompt and accurate diagnosis and treatment.
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Affiliation(s)
- Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea.
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41
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Contribution of mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging in the diagnosis and differentiation of uterine cervical carcinoma. Eur Radiol 2016; 27:2400-2410. [DOI: 10.1007/s00330-016-4596-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/24/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
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42
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Xu XQ, Choi YJ, Sung YS, Yoon RG, Jang SW, Park JE, Heo YJ, Baek JH, Lee JH. Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging. Korean J Radiol 2016; 17:641-9. [PMID: 27587952 PMCID: PMC5007390 DOI: 10.3348/kjr.2016.17.5.641] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 05/17/2016] [Indexed: 12/25/2022] Open
Abstract
Objective To investigate the correlation between perfusion- and diffusion-related parameters from intravoxel incoherent motion (IVIM) and those from dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted imaging in tumors and normal muscles of the head and neck. Materials and Methods We retrospectively enrolled 20 consecutive patients with head and neck tumors with MR imaging performed using a 3T MR scanner. Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were derived from bi-exponential fitting of IVIM data obtained with 14 different b-values in three orthogonal directions. We investigated the correlation between D, f, and D* and model-free parameters from the DCE-MRI (wash-in, Tmax, Emax, initial AUC60, whole AUC) and the apparent diffusion coefficient (ADC) value in the tumor and normal masseter muscle using a whole volume-of-interest approach. Pearson's correlation test was used for statistical analysis. Results No correlation was found between f or D* and any of the parameters from the DCE-MRI in all patients or in patients with squamous cell carcinoma (p > 0.05). The ADC was significantly correlated with D values in the tumors (p < 0.001, r = 0.980) and muscles (p = 0.013, r = 0.542), despite its significantly higher value than D. The difference between ADC and D showed significant correlation with f values in the tumors (p = 0.017, r = 0.528) and muscles (p = 0.003, r = 0.630), but no correlation with D* (p > 0.05, respectively). Conclusion Intravoxel incoherent motion shows no significant correlation with model-free perfusion parameters derived from the DCE-MRI but is feasible for the analysis of diffusivity in both tumors and normal muscles of the head and neck.
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Affiliation(s)
- Xiao Quan Xu
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ra Gyoung Yoon
- Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Korea
| | - Seung Won Jang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Young Jin Heo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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43
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De Luca A, Bertoldo A, Froeling M. Effects of perfusion on DTI and DKI estimates in the skeletal muscle. Magn Reson Med 2016; 78:233-246. [PMID: 27538923 DOI: 10.1002/mrm.26373] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/28/2016] [Accepted: 07/18/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE In this study, we evaluated the effects of perfusion of the skeletal muscle on diffusion tensor imaging (DTI) and diffusional kurtosis imaging (DKI) parameters and their reproducibility. METHODS Diffusion tensor imaging and DKI models, with and without intravoxel incoherent motion (IVIM) correction, were applied to simulated data at different physiological conditions and signal-to-noise ratio levels. Next, the same models were applied to data of the right calf of five healthy volunteers, acquired twice at 3 telsa. For six muscles, we evaluated the correlation of the perfusion signal fraction, with parameters derived from DTI and DKI, and performed repeatability analysis with and without IVIM correction. Additionally, the IVIM correction was compared to a multishell acquisition approach that minimizes perfusion effects on DTI estimates. RESULTS Simulations and acquired data showed that DTI and DKI estimates were biased proportionally to the perfusion signal fraction, and that IVIM correction was needed for accurate estimation of the DTI and DKI parameters. However, taking perfusion into account did not improve repeatability. CONCLUSION Blood perfusion has an effect on DTI and DKI estimations, but it can be minimized with IVIM correction or multishell acquisition strategies. Magn Reson Med 78:233-246, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Alberto De Luca
- Department of Information Engineering, University of Padova, Padova, Italy.,Department of Radiology, University Medical Center, Utrecht, The Netherlands.,Neuroimaging Lab, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
| | | | - Martijn Froeling
- Department of Radiology, University Medical Center, Utrecht, The Netherlands
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44
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Yu XP, Hou J, Li FP, Wang H, Hu PS, Bi F, Wang W. Intravoxel Incoherent Motion Diffusion Weighted Magnetic Resonance Imaging for Differentiation Between Nasopharyngeal Carcinoma and Lymphoma at the Primary Site. J Comput Assist Tomogr 2016; 40:413-8. [PMID: 26953769 PMCID: PMC4872642 DOI: 10.1097/rct.0000000000000391] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/16/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the utility of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (DWI) for differentiating nasopharyngeal carcinoma (NPC) from lymphoma. METHODS Intravoxel incoherent motion-based parameters including the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and fD* (the product of D* and f) were retrospectively compared between 102 patients (82 with NPC, 20 with lymphoma) who received pretreatment IVIM DWI. RESULTS Compared with lymphoma, NPC exhibited higher ADC, D, D*, fD* values (P < 0.001) and f value (P = 0.047). The optimal cutoff values (area under the curve, sensitivity, and specificity, respectively) for distinguishing the 2 tumors were as follows: ADC value of 0.761 × 10 mm/s (0.781, 93.90%, 55.00%); D, 0.66 × 10 mm/s (0.802, 54.88%, 100.00%); D*, 7.89 × 10 mm/s (0.898, 82.93%, 85.00%); f, 0.29 (0.644, 41.46%, 95.00%); and fD*, 1.99 × 10 mm/s (0.960, 85.37%, 100.00%). CONCLUSIONS Nasopharyngeal carcinoma exhibits different IVIM-based imaging features from lymphoma. Intravoxel incoherent motion DWI is useful for differentiating lymphoma from NPC.
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Affiliation(s)
- Xiao-Ping Yu
- From the *Department of Diagnostic Radiology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University; †Department of Radiology, the Third Xiangya Hospital, Central South University; and ‡Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan, PR China
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45
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Suo S, Cao M, Zhu W, Li L, Li J, Shen F, Zu J, Zhou Z, Zhuang Z, Qu J, Chen Z, Xu J. Stroke assessment with intravoxel incoherent motion diffusion-weighted MRI. NMR IN BIOMEDICINE 2016; 29:320-328. [PMID: 26748572 DOI: 10.1002/nbm.3467] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 11/19/2015] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
Intravoxel incoherent motion (IVIM) diffusion-weighted MRI can simultaneously measure diffusion and perfusion characteristics in a non-invasive way. This study aimed to determine the potential utility of IVIM in characterizing brain diffusion and perfusion properties for clinical stroke. The multi-b-value diffusion-weighted images of 101 patients diagnosed with acute/subacute ischemic stroke were retrospectively evaluated. The diffusion coefficient D, representing the water apparent diffusivity, was obtained by fitting the diffusion data with increasing high b-values to a simple mono-exponential model. The IVIM-derived perfusion parameters, pseudodiffusion coefficient D*, vascular volume fraction f and blood flow-related parameter fD*, were calculated with the bi-exponential model. Additionally, the apparent diffusion coefficient (ADC) was fitted according to the mono-exponential model using all b-values. The diffusion parameters for the ischemic lesion and normal contralateral region were measured in each patient. Statistical analysis was performed using the paired Student t-test and Pearson correlation test. Diffusion data in both the ischemic lesion and normal contralateral region followed the IVIM bi-exponential behavior, and the IVIM model showed better goodness of fit than the mono-exponential model with lower Akaike information criterion values. The paired Student t-test revealed significant differences for all diffusion parameters (all P < 0.001) except D* (P = 0.218) between ischemic and normal areas. For all patients in both ischemic and normal regions, ADC was significantly positively correlated with D (both r = 1, both P < 0.001) and f (r = 0.541, P < 0.001; r = 0.262, P = 0.008); significant correlation was also found between ADC and fD* in the ischemic region (r = 0.254, P = 0.010). For all pixels within the region of interest from a representative subject in both ischemic and normal regions, ADC was significantly positively correlated with D (both r = 1, both P < 0.001), f (r = 0.823, P < 0.001; r = 0.652, P < 0.001) and fD* (r = 0.294, P < 0.001; r = 0.340, P < 0.001). These findings may have clinical implications for the use of IVIM imaging in the assessment and management of acute/subacute stroke patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shiteng Suo
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengqiu Cao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wanqiu Zhu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Li
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Li
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fei Shen
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinyan Zu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zien Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiguo Zhuang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Zengai Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Hectors SJ, Wagner M, Besa C, Bane O, Dyvorne HA, Fiel MI, Zhu H, Donovan M, Taouli B. Intravoxel incoherent motion diffusion-weighted imaging of hepatocellular carcinoma: Is there a correlation with flow and perfusion metrics obtained with dynamic contrast-enhanced MRI? J Magn Reson Imaging 2016; 44:856-64. [PMID: 26919327 DOI: 10.1002/jmri.25194] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To assess the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) metrics in hepatocellular carcinoma (HCC) and liver parenchyma. MATERIALS AND METHODS Twenty-five patients with HCC (M/F 23/2, mean age 58 years) underwent abdominal MRI at 1.5 or 3.0T, including IVIM-DWI (with 16 b-values) and DCE-MRI (3D FLASH sequence, mean temporal resolution of 2.3 sec). IVIM-DWI parameters (pseudodiffusion coefficient, D*, diffusion coefficient, D, and perfusion fraction, PF) were quantified in HCC lesions and liver parenchyma using a Bayesian fitting algorithm. DCE-MRI parameters (arterial flow, Fa , portal flow, Fp , total flow, Ft , mean transit time, MTT, distribution volume, DV, and arterial fraction, ART) were quantified using a dual-input single-compartment model. Correlations between IVIM-DWI and DCE-MRI parameters were assessed using a Spearman correlation test. RESULTS Thirty-three HCC lesions (average size 5.0 ± 3.6 cm) were analyzed. D, D*, and PF were all significantly lower in HCC vs. liver (P < 0.05). Significantly higher Fa and ART and lower Fp were observed in HCC vs. liver (P < 0.001). Significant moderate to strong negative correlations were observed between ART and D* (r = -0.443, P = 0.028), ART and PF (r = -0.536, P = 0.006), ART and PFxD* (r = -0.655, P < 0.001), Fa and PF (r = 0.455, P = 0.023), and Fa and PFxD* (r = -0.475, P = 0.018) in liver parenchyma. There was no significant correlation between IVIM-DWI and DCE-MRI metrics in HCC lesions. CONCLUSION IVIM-DWI and DCE-MRI provide nonredundant information in HCC, while they correlate in liver parenchyma. These findings may be secondary to predominant portal inflow in the liver and tortuous vasculature and tissue heterogeneity in tumors. J. MAGN. RESON. IMAGING 2016;44:856-864.
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Affiliation(s)
- Stefanie J Hectors
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cecilia Besa
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Octavia Bane
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hadrien A Dyvorne
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M Isabel Fiel
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hongfa Zhu
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Donovan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. .,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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de Perrot T, Scheffler M, Boto J, Delattre BMA, Combescure C, Pusztaszeri M, Tille JC, Iselin C, Vallée JP. Diffusion in prostate cancer detection on a 3T scanner: How many b-values are needed? J Magn Reson Imaging 2016; 44:601-9. [DOI: 10.1002/jmri.25206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/09/2016] [Indexed: 12/30/2022] Open
Affiliation(s)
- Thomas de Perrot
- Division of Radiology; Geneva University Hospitals; Geneva Switzerland
| | - Max Scheffler
- Division of Radiology; Geneva University Hospitals; Geneva Switzerland
| | - José Boto
- Division of Radiology; Geneva University Hospitals; Geneva Switzerland
| | | | | | - Marc Pusztaszeri
- Division of Clinical Pathology; Geneva University Hospitals; Geneva Switzerland
| | | | - Christophe Iselin
- Division of Urologic Surgery; Geneva University Hospitals; Geneva Switzerland
| | - Jean-Paul Vallée
- Division of Radiology; Geneva University Hospitals; Geneva Switzerland
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48
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Marzi S, Stefanetti L, Sperati F, Anelli V. Relationship between diffusion parameters derived from intravoxel incoherent motion MRI and perfusion measured by dynamic contrast-enhanced MRI of soft tissue tumors. NMR IN BIOMEDICINE 2016; 29:6-14. [PMID: 26602061 DOI: 10.1002/nbm.3446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/21/2015] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
Our aim was to evaluate the link between diffusion parameters measured by intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and the perfusion metrics obtained with dynamic contrast-enhanced (DCE) MRI in soft tissue tumors (STTs). Twenty-eight patients affected by histopathologically confirmed STT were included in a prospective study. All patients underwent both DCE MRI and IVIM DWI. The perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were estimated using a bi-exponential function to fit the DWI data. DCE MRI was acquired with a temporal resolution of 3-5 s. Maps of the initial area under the gadolinium concentration curve (IAUGC), time to peak (TTP) and maximum slope of increase (MSI) were derived using commercial software. The relationships between the DCE MRI and IVIM DWI measurements were assessed by Spearman's test. To exclude false positive results under multiple testing, the false discovery rate (FDR) procedure was applied. The Mann-Whitney test was used to evaluate the differences between all variables in patients with non-myxoid and myxoid STT. No significant relationship was found between IVIM parameters and any DCE MRI parameters. Higher f and D*f values were found in non-myxoid tumors compared with myxoid tumors (p = 0.004 and p = 0.003, respectively). MSI was significantly higher in non-myxoid tumors than in myxoid tumors (p = 0.029). From the visual assessments of single clinical cases, both f and D*f maps were in satisfactory agreement with DCE maps in the extreme cases of an avascular mass and a highly vascularized mass, whereas, for tumors with slight vascularity or with a highly heterogeneous perfusion pattern, this association was not straightforward. Although IVIM DWI was demonstrated to be feasible in STT, our data did not support evident relationships between perfusion-related IVIM parameters and perfusion measured by DCE MRI.
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Affiliation(s)
- Simona Marzi
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy
| | - Linda Stefanetti
- Department of Radiology, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Francesca Sperati
- Biostatistics-Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Department, Regina Elena National Cancer Institute, Rome, Italy
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Su GY, Xu XQ, Wang YY, Hu H, Shen J, Hong XN, Shi HB, Wu FY. Feasibility study of using intravoxel incoherent motion mri to detect parotid gland abnormalities in early-stage Sjögren syndrome patients. J Magn Reson Imaging 2015; 43:1455-61. [PMID: 26583877 DOI: 10.1002/jmri.25096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/02/2015] [Indexed: 12/20/2022] Open
Affiliation(s)
- Guo-Yi Su
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Xiao-Quan Xu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Yan-Yan Wang
- Department of Rheumatology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Hao Hu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Jie Shen
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Xun-Ning Hong
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Hai-Bin Shi
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Fei-Yun Wu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
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